Digital Commons Network^™

Imaging Findings Associated With Cognitive Performance In Primary Lateral Sclerosis And Amyotrophic Lateral Sclerosis, Avner Meoded, Justin Y. Kwan, Tracy L. Peters, Edward D. Huey, Laura E. Danielian, Edythe Wiggs, Arthur Morrissette, Tianxia Wu, James W. Russell, Elham Bayat, Jordan Grafman, Mary Kay Floeter

Neurology Faculty Publications

Introduction: Executive dysfunction occurs in many patients with amyotrophic lateral sclerosis (ALS), but it has not been well studied in primary lateral sclerosis (PLS). The aims of this study were to (1) compare cognitive function in PLS to that in ALS patients, (2) explore the relationship between performance on specific cognitive tests and diffusion tensor imaging (DTI) metrics of white matter tracts and gray matter volumes, and (3) compare DTI metrics in patients with and without cognitive and behavioral changes.

Methods: The Delis-Kaplan Executive Function System (D-KEFS), the Mattis Dementia Rating Scale (DRS-2), and other behavior and mood scales were …

Impact Of Varied Low Resolution Phantoms On Intensity Modulated Proton Therapy Dose Distributions, Aarohi Shyam Padhye

Theses Digitization Project

The primary purpose of this thesis is to discuss the usefulness of image segmentation techniques in creating accurate proton dose distribution plans. The calculation of the proton dose distribution has to take into account the material (tissue, bone, brain) in the treatment area of the patients body.

Stereotactic Localization And Targeting Accuracy For Experimental Proton Radiosurgery, Yin Chen

Theses Digitization Project

The purpose of this study was to improve an existing experimental proton radiosurgery system at Loma Linda University Medical Center to reach sub-millimeter accuracy before proton radiosurgery with narrow beams can be used in a clinical trial. Protons, different from photons (i.e., x-rays or gamma rays), are charged with particles that slow down in matter and release a burst of energy near the end of their range (maximum depth of penetration), which is called the Bragg peak, named after the physicist William Henry Bragg who discovered it in 1903. Photon beams deliver most doses over a large area near the …

Fiducial-Free Alignment Verification Techniques For Intracranial Radiosurgery, Kenneth Matthew Williams

Theses Digitization Project

This thesis serves as the basis for a method using image registration to automate patient alignment in an effort to eliminate the dependency on the fiducial markers as well as improve the accuracy efficiency of the alignment process. Proton beams are an external beam modality of radiation therapy that can be used effectively for radiosurgical applications due to the dosimetry advantage of the Bragg peak. The Bragg peak is a phenomenon exploited by proton beam therapy to concentrate the effect of the beams on the tumor while minimizing damage to critical structures and other health tissues within the patient.

Medical Education Digest, Vol. 15 No. 1 (January/February 2013), Nova Southeastern University

Medical Education Digest

No abstract provided.

A New Phantom And Gradient Isocenter Estimation For Magnetic Resonance Imaging Distortion Correction, Zongqi Cai

Theses Digitization Project

The purpose of this study was to develop and implement a numerical software based method that can accurately correct the distortion of MR images generated by 3T MRI scanner. To accomplish this, a new phantom has been designed from scratch to capture the distortions inside 3T MRI scanner. An algorithm has been developed, based on the unique geometric feature of the new phantom, to estimate the location of gradient isocenter of the magnetic field inside 3T MRI scanner for the first time.

Alternative Hull Detection Techniques For Preprocessing In Proton Computed Tomography Reconstruction, Blake Edward Schultze

Theses Digitization Project

The purpose of this study was to develop computationally efficient hull detection techniques appropriate for image reconstruction using sparse matrices. The hull detection techniques investigated were space carving (SC), modified space carving (MSC), and space modeling (SM) and these were compared to the cone-beam version of filtered back projection (FBP) algorithm in terms of their computation time and the quality of the object hull they produced.

Vancomycin And Gentamicin Pharmacokinetic Alterations In An Adolescent Amputee, Kristen R. Nichols, Kari M. Edison, Michelle D. Rosenbaum, Chad A. Knoderer

Scholarship and Professional Work – COPHS

A 14-year-old male with bilateral above-the-knee amputations presented to our hospital for treatment of a skin and soft-tissue infection. We report the experience of vancomycin and gentamicin therapy in this patient. Because these medications require weight-based dosages and pharmacokinetic monitoring of serum levels, it was necessary to obtain peak and trough levels of the two drugs in order to determine the pharmacokinetic differences in this patient compared to those in an adolescent male without amputations. To our knowledge, this is the first report describing pharmacokinetic differences in an adolescent amputee.

Graduate Medical Education 2012-2013 Annual Report, Children's Mercy Hospital

GME Annual Reports

Annual report of the Children's Mercy Hospital Graduate Medical Education department, including pediatric residency, internal medicine/pediatrics residency, fellowship programs, medical students, continuing medical education, and library services.

Pge 2 Desensitizes Β -Agonist Effect On Human Lung Fibroblast-Mediated Collagen Gel Contraction Through Opregulating Pde4, Qiuhong Fang, Yingmin Ma, Jing Wang, Joel Michalski, Stephen I. Rennard, Xiangde Liu

Journal Articles: Pulmonary & Critical Care Med

In the current study, we investigated the effect of a long-acting β -agonist (salmeterol) and a phosphodiesterase 4 (PDE4) inhibitor (cilomilast) on human lung fibroblast-mediated collagen gel contraction. Higher concentrations of salmeterol (10(-7) and 10(-6) M) inhibited fibroblast-mediated collagen gel contraction. No effect was observed with cilomilast alone (up to 10(-5) M). In the presence of 10(-8) M salmeterol, however, cilomilast could significantly inhibit fibroblast-mediated collagen gel contraction in a concentration-dependent manner (10(-7) ~10(-5) M). Blockade of endogenous PGE2 by indomethacin further potentiated the inhibitory effect of salmeterol on fibroblast-mediated collagen gel contraction, but it did not affect cilomilast's effect. …

Com Outlook Winter 2013, College Of Osteopathic Medicine

COM Outlook

No abstract provided.

Cost-Savings Analysis Of Telemedicine Use For Ophthalmic Screening In A Rural Appalachian Health Clinic, D. Russell Richardson, Russell Fry Ii, Michael Krasnow Do, Phd

Ophthalmology

Life in mountainous, rural areas poses unique obstacles for ophthalmic care--notably, a lack of access to ophthalmologists and cost of care. Using telemedicine as a screening tool addresses both issues for diabetic retinopathy (DR) screening, as fundus photography has been determined to be sensitive and specific when screening for DR.^1,2 The American Diabetes Association places a Grade E recommendation on fundus photography as a screening tool.³ We analyze the financial impact of ophthalmic telemedicine in a mountainous, rural health clinic in West Virginia over a seven year period from 2003-2009. At-risk patients are screened with a fundus camera …

Susceptibility To Fatty Acid-Induced Β-Cell Dysfunction Is Enhanced In Prediabetic Diabetes-Prone Biobreeding Rats: A Potential Link Between Β-Cell Lipotoxicity And Islet Inflammation, Christine Tang, Anthony E. Naassan, Astrid Chamson-Reig, Khajag Koulajian, Tracy T. Goh, Frederick Yoon, Andrei I. Oprescu, Husam Ghanim, Gary F. Lewis, Paresh Dandona, Marc Y. Donath, Jan A. Ehses, Edith Arany, Adria Giacca

Paediatrics Publications

β-Cell lipotoxicity is thought to play an important role in the development of type 2 diabetes. However, no study has examined its role in type 1 diabetes, which could be clinically relevant for slow-onset type 1 diabetes. Reports of enhanced cytokine toxicity in fat-laden islets are consistent with the hypothesis that lipid and cytokine toxicity maybe synergistic. Thus, β-cell lipotoxicity could be enhanced in models of autoimmune diabetes. To determine this, we examined the effects of prolonged free fatty acids elevation on β-cell secretory function in the prediabetic diabetes-prone BioBreeding (dp-BB) rat, its diabetes-resistant BioBreeding (dr-BB) control, and normal Wistar-Furth …

Multi-Modality Assessment Of Language Function, Erik Carmen Brown

Wayne State University Dissertations

The work presented as part of this dissertation represents a multi-modality study of language structure and function. The primary functional modality employed is task-related electrocorticography (ECoG). This is complemented by discussion and evaluation of previously published functional magnetic resonance imaging (fMRI) data. Language-related structure is explored using diffusion-weighted magnetic resonance imaging in conjunction with ECoG data. The scientific questions pursued are broad and include reevaluation of previously proposed theories.

We start by taking the first steps in validating our naming-related ECoG approach by comparing our results from a small cohort of patients to the clinical gold-standard technique of electrical brain …

Linking Environmental Toxicant Exposure To Diabetes Susceptibility, Jannifer Beth Tyrrell

Wayne State University Dissertations

An important and unresolved question in the environmental health field is whether exposure to common environmental toxicants, such as dioxin and heavy metals like Pb, increase the risk of developing diabetes, especially in combination with other common metabolic stressors such as obesity.

Previous studies suggested that dioxin exposure increased peripheral insulin resistance but did not appear to cause fasting hyperglycemia or elevated hepatic glucose output. In concordance with those findings we observed that dioxin treatment caused a strong suppression of the expression of the key hepatic gluconeogenic genes PEPCK and G6Pase. However, this suppression was not solely mediated by the …

White Matter Integrity And Age Related Differences In Reaction Time Components, Yiqin Yang

Wayne State University Dissertations

Reduced speed in information processing is a well-documented phenomenon associated with advanced aging. Age-related deterioration in white matter integrity might play a role in age-related increase in reaction time (RT). However, the association between microstructural differences in particular white matter regions or tracts with RT is unclear. Decomposing RT into parts might be a better way to understand the relationship due to multiple processes involved in RT. In a lifespan sample of 90 healthy normotensive participants, this study examined the association between RT components derived from the Ratcliff diffusion model with age related difference in DTI indices of a wide …

Middle Ear Myoclonus: Two Informative Cases And A Systematic Discussion Of Myogenic Tinnitus, Aviva Ellenstein, Nadia Yusuf, Mark Hallett

Neurology Faculty Publications

Background: The term middle ear myoclonus (MEM) has been invoked to explain symptoms of tinnitus presumably caused by the dysfunctional movement of either of the two muscles that insert in the middle ear: tensor tympani and stapedius. MEM has been characterized through heterogeneous case reports in the otolaryngology literature, where clinical presentation is variable, phenomenology is scarcely described, the pathogenic muscle is usually not specified, natural history is unknown, and the presumptive definitive treatment, tensor tympani or stapedius tendon lysis, is inconsistently effective. It is not surprising that no unique acoustogenic mechanism or pathophysiologic process has been identified to explain …

Autoclaved Tumor Bone For Skeletal Reconstruction In Paediatric Patients: A Low Cost Alternative In Developing Countries, Masood Umer, Hafiz Muhammad Umer, Irfan Qadir, Haroon Rashid, Rabia Awan, Raza Askari, Shamvil Ashraf

Section of Orthopaedic Surgery

We reviewed in this series forty patients of pediatric age who underwent resection for malignant tumors of musculoskeletal system followed by biological reconstruction. Our surgical procedure for reconstruction included (1) wide en bloc resection of the tumor; (2) curettage of tumor from the resected bone; (3) autoclaving for 8 minutes (4) bone grafting from the fibula (both vascularized and nonvascularized fibular grafts used); (5) reimplantation of the autoclaved bone into the host bone defect and fixation with plates. Functional evaluation was done using MSTS scoring system. At final followup of at least 18 months (mean 29.2 months), 31 patients had …

Perception Of Final Year Undergraduate Medical Students Towards Family Medicine In Dar Es Salaam, Tanzania, Eric Luggar Aghan

Master of Medicine in Family Medicine

Primary health care was identified as the ideal model of health care delivery during the Alma Atta conference in USSR in 1978. The World Health Organization urged member countries to adopt it as a model of health care service delivery to their people. Since then many countries have adopted a primary health care model including Tanzania. In countries such as Cuba and Costa Rica where primary health care has successfully been implemented, access to affordable and quality health care service to all has resulted in lowered morbidity, mortality, improved quality and longevity of life. The success story behind primary health …

Prevalence Of Acute Kidney Injury Using Urine Neutrophil Gelatinase Associated Lipocalin As An Early Biomarker In Neonates With Perinatal Asphyxia, Farida Essajee

Master of Medicine in Paediatrics and Child Health

Introduction: Perinatal asphyxia is a major cause of neonatal morbidity and mortality. Acute kidney injury (AKI) is a common complication of perinatal asphyxia occurring in up to 61% of the neonates. Currently the diagnosis of AKI is based on serum creatinine levels and clinically by oliguria, however these are late markers of the disease. More novel biomarkers are emerging that predict the diagnosis early. Current research indicates urine NGAL as an early marker for AKI, yet there is paucity of data about its use in term neonates with perinatal asphyxia. Objectives: This study aimed to investigate the prevalence of acute …

Gently Into The Good Night: Toward A Compassionate Response To End-Stage Illness, George P. Smith Ii

Scholarly Articles

End-of-life decision making by health care providers must respect individual patient values. Indeed, these values must always be viewed as the baseline for developing and pursuing patient-centered palliative care for those with terminal illness. Co-ordinate with this fundamental bioethics principle is that of beneficence or, in other words, respect for conduct which benefits the dying patient by alleviating end-stage suffering — be it physical or existential. Compassion, charity, agape and/or just common sense, should be a part of setting normative standards and of legislative and judicial responses to the task of managing death. Aided by the principles of medical futility, …

Systems Analysis Reveals A Transcriptional Reversal Of The Mesenchymal Phenotype Induced By Snail-Inhibitor Gn-25, Asfar S. Azmi, Aliccia Bollig-Fischer, Bin Bao, Bum-Joon Park, Sun-Hye Lee, Gyu Yong-Song, Gregory Dyson, Chandan K. Reddy, Fazlul H. Sarkar, Ramzi M. Mohammad

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

HMLEs (HMLE-SNAIL and Kras-HMLE, Kras-HMLE-SNAIL pairs) serve as excellent model system to interrogate the effect of SNAIL targeted agents that reverse epithelial-to-mesenchymal transition (EMT). We had earlier developed a SNAIL-p53 interaction inhibitor (GN-25) that was shown to suppress SNAIL function. In this report, using systems biology and pathway network analysis, we show that GN-25 could cause reversal of EMT leading to mesenchymal-to-epithelial transition (MET) in a well-recognized HMLE-SNAIL and Kras-HMLE-SNAIL models.

Results

GN-25 induced MET was found to be consistent with growth inhibition, suppression of spheroid forming capacity and induction of apoptosis. Pathway network analysis of mRNA expression …

Astrue V. Capato: Forcing A Shoe That Doesn't Fit, Courtney Hannon

Journal of Health Care Law and Policy

No abstract provided.

Seeing The Justice System Through A Soldier's Eyes: A Call To Action For Maryland To Adopt A Veterans Treatment Court System, Beth Totman

Journal of Health Care Law and Policy

No abstract provided.

Midterm Results Of Bovine Jugular Vein Conduit For Right Ventricular Outflow Tract Reconstruction, Shazia Samad Mohsin, Maria Tariq Siddiqui, Abdul Sattar Shaikh, Mehnaz Atiq, Muneer Amanullah

Department of Paediatrics and Child Health

Objective: To evaluate the midterm results of Contegra conduit.
Methods: The retrospective study comprised patient record at Aga Khan University Hospital, Karachi, of conduits implanted between May 2007 and June 2012. Data collection was made from the clinical notes and from serial echocardiograms by a single cardiologist. The last followup echocardiography was done at the time of data collection in June 2012. SPSS 19 was used for statistical analysis.
Results: A total of 18 conduits had been implanted (16-22mm) during the study period. Median age at the time of surgery was 9 years (range: 2.5-16 years). Early mortality was seen …

William Edwards Ladd, M.D. (1880-1967): The Description Of His Bands., Pei-Wen Lim, Md, Niels D. Martin, Md, Barry A. Hicks, Md, Charles J. Yeo, Md, Scott W. Cowan, Md

Department of Surgery Gibbon Society Historical Profiles

In the early 20th century, an established surgical specialty catering to pediatric surgery did not exist, and pediatric surgical ailments were operated on by general surgeons. With his devotion to childhood diseases and his unique thinking in surgical development, William E. Ladd would become a leading figure in America by pioneering the field of pediatric surgery.

Dynamic Recruitment Of Micrornas To Their Mrna Targets In The Regenerating Liver., Jonathan Schug, Lindsay B Mckenna, Gabriel Walton, Nicholas Hand, Sarmistha Mukherjee, Kow Essuman, Zhongjie Shi, Yan Gao, Karen Markley, Momo Nakagawa, Vasumathi Kameswaran, Anastassios Vourekas, Joshua R Friedman, Klaus H Kaestner, Linda E Greenbaum

Department of Cancer Biology Faculty Papers

BACKGROUND: Validation of physiologic miRNA targets has been met with significant challenges. We employed HITS-CLIP to identify which miRNAs participate in liver regeneration, and to identify their target mRNAs.

RESULTS: miRNA recruitment to the RISC is highly dynamic, changing more than five-fold for several miRNAs. miRNA recruitment to the RISC did not correlate with changes in overall miRNA expression for these dynamically recruited miRNAs, emphasizing the necessity to determine miRNA recruitment to the RISC in order to fully assess the impact of miRNA regulation. We incorporated RNA-seq quantification of total mRNA to identify expression-weighted Ago footprints, and developed a microRNA …

Missing The Boat: Odds For The Patients Who Leave Ed Without Being Seen, Jabeen Fayyaz, Munawar Khursheed, Mohammed Umer Mir, Amber Mehmood

Department of Emergency Medicine

BACKGROUND:

A patient left without being seen is a well-recognized indicator of Emergency Department overcrowding. The aim of this study was to define the characteristics of LWBS patients, their rates and associated factors from a tertiary care hospital of Pakistan.

METHODS:

A retrospective patient record review was undertaken. All patients presenting to the Aga Khan University Hospital, Karachi, between April and December of the year 2010, were included in the study. Information was collected on age, sex, presenting complaints, ED capacity, month, time, shift, day of the week, and waiting times in the ED. A basic descriptive analysis was made …

Breath And Urine Alcohol Level Analysis To Increase Student Awareness Of Road Safety., Kim Daly

Students Learning with Communities

The aim of this project was to increase student’s awareness of road safety and the relationship between alcohol and driving. This was carried out in conjunction with the Garda Road Safety Unit and the DIT interdisciplinary project known as CARS, College Awareness of Road Safety. This project was carried out last year by another student therefore the aim this year was to build and expand on the work that had been done so far. Increasing the student’s awareness was achieved by speaking to class groups to explain the project and asking them to take part by supplying samples of breath …

Anxiety In Disabling Osteoarthritis: Implications For Research And Practice, Ray Marks

Publications and Research

No abstract provided.